By Ryoichi Oyasu M.D., Ximing J. Yang M.D., Ph.D., Osamu Yoshida M.D., Ph.D. (auth.)
The primary position of the diagnostic surgical pathologist is to serve a sufferer via supporting the clinician in control of the patient's care. In that capacity,the pathologist offers the very important informationthat might be without delay and in some way precious in guiding the clinician towards the main acceptable treatment. the fabric pathologists obtain most ordinarily is a biopsy or part of an organ got rid of after a definitive seasoned- dure. To extract worthwhile info, pathological review proceeds in line with a collection of directions. easily reporting a prognosis of melanoma is insufficient. designated more information is required in order that the clinician can cross directly to identify a the- peutic plan as wanted. To most sensible serve the sufferer, shut interplay among the cli- cian and the pathologist is key. within the box of urological pathology, there are difficulties particular to the program. normally, within the prostate, due to its situation, there's little room for a general practitioner to paintings to procure sufficient resection margins, in contrast to with many different organs. therefore, questions come up reminiscent of "What constitutes an enough surgical margin?" "What is the importance of extraprostatic extension of neoplasm that remains contained in the resection margin?" and "What is the importance of neoplastic glands came upon at the resection margin marked with the ink?" it's been proven prostate needle middle biopsy can generate a lot info that's instantly necessary in predicting the level of melanoma within the prostate and, therefore, the end result for the patient.
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Extra resources for Questions in Daily Urologic Practice: Updates for Urologists and Diagnostic Pathologists
Example text
Urology 58:746-751. Question 9 What are the neuroendocrine cells in prostate cancer? From where are these cells derived? What is the clinical implication of neuroendocrine differentiation in prostate cancer? Answer Neuroendocrine cells are the third type of pr ostatic epithelial cells in addition to secre tory cells and basal cells in normal prostate glands. Ne uro endocrine cells in pros tat e cancer are believed to derive from neur oend ocrine cells or their stem precursors. Pros ta te cancer with a neu roend ocrine phen otype exists in two for ms: (1) as a tum or compose d entire ly of neu roend ocrine-type malignant cells; and (2) as a tum or that is a conve ntional-type cancer but has neur oen docrine-differ enti ated tum or cells as an integral compone nt.
Five cases had EPE, and two of them had positive surgical margins. In all cases, seminal vesicles and lymph nodes were negative for tumor. The location of the tumors was heterogeneous; the central (periurethral) region was predominantly involved in 25 cases (390/0), and peripheral tumors predominated in 39 cases (610/0). An important observation was that in 16 cases the tumor involved the apical region, and that in an additional 25 cases (390/0) the tumor focally extended toward the apex. These data suggested that a substantial number of prostates removed for stage al tumor had clinically important cancer involving the PZ.
Cancer 65:2328-2337. 13. McNeal JE, Redwine EA, Freiha ES, Stamey TA(1988) Zonal distribution of prostate adenocarcinoma: correlation with histologic pattern and distribution of spread. Am J Surg PathoI12:897-906. 14. Kabalin IN, McNeal JE, Price HM, Freiha FS, Stamey TA (1989) Unsuspected adenocarcinoma of the prostate in patients undergoing cystoprostatectomy for other causes: incidence, histology, and morphometric observations. J Urol141:1091-1094. Question 6 What are the characteristics of transition zone cancer?